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Are You Really Hoarding Coronavirus in Your Balls?

A recent study suggests there might be a link between testicles and COVID-19, but what does that actually mean?

Men are twice as likely to die from coronavirus than women in many parts of the world. We don’t yet know why this is: It could be because men are more likely to partake in risky behavior, like cigarette smoking, that could lead to the kind of health issues more likely to make the virus fatal. It could be because they’re less likely to receive early medical care. Or it could simply be because most men have testicles — and apparently, coronavirus testicles, at that.

According to one study published on April 16, 2020, this appears to be one possibility. But is having testicles actually a cause for concern? 

The study, catchily titled “Delayed Clearance of SARS-CoV2 in Male Compared to Female Patients: High ACE2 Expression in Testes Suggests Possible Existence of Gender-Specific Viral Reservoirs,” by researchers at the Albert Einstein College of Medicine in the Bronx, and Kasturba Hospital for Infectious Diseases in Mumbai, found that female coronavirus patients were cleared of the virus two days earlier than men on average. 

In addition to this finding, the researchers also studied levels of protein enzyme ACE2 throughout the body. When the virus enters the body, it attaches to this protein, which people of all genders carry in their lungs, gastrointestinal tract and heart. However, what is notable is that this protein is found in the testicles, but not within ovarian tissue. Moreover, testicles were found to be one of the highest sites of this protein. 

It’s thought, then, that perhaps people with testicles carry the virus longer. After all, testicles are indeed a form of storage, and could potentially serve as a “reservoir” for the virus before it invades the immune system. 

But this is just one theory. Your testicles can carry a lot of things — semen alone can contain, among other things, carcinogens, hepatitis and whatever the hell Simian foamy virus is — and not necessarily infect the testicle-haver. So though men were found to be viral with coronavirus longer and have more ACE2 in their testicles, there’s no indication yet that these things are causal. 

According to Dr. Paul Turek, urologist and men’s sexual health expert, testicles are unique in that they are “immune sanctuaries.” Like the eyes and the brain, the immune system “does not tread there.” However, this does not actually mean anything in terms of their ability to become infected. Clinically, urologists are not seeing increased cases of COVID-19 in relation to the testicles.

“The brain and eye also have ACE2 receptors and we are not seeing lots of eye and brain infections with COVID-19 either,” he says. “Just because it’s there at the scene doesn’t mean it’s part of the crime. No guilt by association here.”

It’s also worth noting that this study was relatively small, containing only 68 people from Mumbai. It’s by no means an accurate representation of the entire population. And while ACE2 is indeed present in testicles, the small intestine carries far more of it, regardless of gender.

“As a testicular immunologist and male reproductive specialist, I would defend the testicle as not being the reason why more men are dying from COVID-19 than women. I would lean more along the lines that men are bigger risk-takers and may exercise less caution in general, along with the fact that they carry a higher disease burden than women as far more likely risk factors for bad outcomes with COVID-19,” says Turek.

So, men should still be concerned about getting the virus, though. Even if the connection between testicles and COVID-19 isn’t there, the fact remains that more men are dying in the pandemic. It just might not be their balls that’s killing them.

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